- Baylor Scott & White Health (Indianapolis, IN)
- …and members. **Key Success Factors** + Demonstrable knowledge in discharge planning, case management , utilization review and different care levels. + ... type and/or level **Job Summary** As a Manager for Utilization Review , you guide and supervise staff....work experience + Hold a valid registration as a Registered Nurse As a health care system… more
- Community Health Network (Indianapolis, IN)
- Registered Nurse ( RN ) Case...cost effectiveness through the integrating and functions of case management , utilization review and ... North has a full-time RN Case Manager position available. The Registered Nurse Case Manager is responsible for the assessment, planning, implementation,… more
- Fresenius Medical Center (Indianapolis, IN)
- **PURPOSE AND SCOPE:** The Inpatient Services Charge Nurse is an additional "responsibility" assigned to the Inpatient Services RN , for a limited period of time, ... duties, as assigned by the Program Manager. The Inpatient Services Charge Nurse ensures appropriate provision of Acute Dialysis Services and treatments within… more
- Fresenius Medical Center (Indianapolis, IN)
- …auditing activities. + Accountable for completion of the Annual Standing Order Review and Internal Classification of Disease (ICD) coding. + Manages clinic ... financials including efficient utilization of supplies or equipment and regular profits and...of supplies or equipment and regular profits and loss review . + Responsible for all required network reporting and… more
- Humana (Indianapolis, IN)
- …supports the goal to put health first? The Prior Authorization, Registered Nurse , RN , Intern will review prior authorization requests for appropriate ... onsite, field, or remote based opportunities. The Prior Authorization, Registered Nurse , RN , Intern will...experience a plus. + Previous experience in prior authorization, utilization management + Experience working with MCG… more
- Elevance Health (Indianapolis, IN)
- …PulsePoint office. This utilization management role is responsible for utilization management review for Behavior Analysis services. **How you will ... equivalent background. + Current active unrestricted license such as RN LCSW LMSW LMHC LPC LBA (as allowed by...is licensed staff supervision. + Previous experience in case management / utilization management with a broad… more
- Highmark Health (Indianapolis, IN)
- …and Sunday required in addition to 3 weekdays** This job implements effective utilization management strategies including: review of appropriateness of ... and offers interventions and/or alternatives. **ESSENTIAL RESPONSIBILITIES** + Implement care management review processes that are consistent with established… more
- Humana (Indianapolis, IN)
- …Family Therapist **(LMFT)** , Licensed Professional Counselor **(LPC)** , Psychologist **(PhD)** , Registered Nurse **( RN )** or other professional license. + ... us put health first** Humana Healthy Horizons in Kentucky is seeking a Utilization Management Behavioral Health Professional 2 who utilizes behavioral health… more
- Guardian Life (Indianapolis, IN)
- …services. Act as a liaison between all parties required in case management to facilitate collaboration toward RTW goals. Utilization of independent ... **Position Summary** The RN Clinical Consultant serves as a clinical resource...issues, when possible, to enhance the customer experience. **Activity** Review and assess claimant subjective reports and objective medical… more
- Community Health Network (Indianapolis, IN)
- …Nursing and/or Master's Degree: MS or MBA (Preferred) + Certifications/Licensures: (Licensed as a Registered Nurse ( RN ) with a valid license to practice in ... the state of Indiana as listed in the Nurse Licensure Compact (NLC) ) + 8+ years: Eight...Analysis Teams responsible for product introductions, value analysis, and utilization review consistent with the Network's policies… more
- Ascension Health (Indianapolis, IN)
- …specialist for staff in the areas of utilization criteria, appeal and review process, and case management system documentation. + Develop staff schedule and ... Vincent Hospital + **Location:** Indianapolis, IN **MUST** have Case Management experience and a LCSW or RN ...Registration: One or more of the following required: + Registered Nurse credentialed from the Indiana Board… more
- Elevance Health (Indianapolis, IN)
- …in an ambulatory or hospital setting or minimum of 1 year of prior utilization management , medical management and/or quality management , and/or ... required. **Preferred Skills, Capabilities, and Experiences** **:** + Familiarity with Utilization Management Guidelines, ICD-9 and CPT-4 coding, and managed… more
- Elevance Health (Indianapolis, IN)
- **Medical Management Nurse ** **Federal Employee Program - FEP** , a proud member of the Elevance Health, Inc. family of companies, it is a powerful combination, ... pm (EST) shift rotation twice a month.** The **Medical Management Nurse ** is responsible for reviewing the...experience and requires a minimum of 2 years clinical, utilization review , or managed care experience; or… more